Provider Demographics
NPI:1558134460
Name:GIBBS COOKS COUNSELING
Entity Type:Organization
Organization Name:GIBBS COOKS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GIBBS-COOKS
Authorized Official - Suffix:
Authorized Official - Credentials:MA/LPC
Authorized Official - Phone:734-560-0173
Mailing Address - Street 1:21701 LINCOLN DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48193-7589
Mailing Address - Country:US
Mailing Address - Phone:734-560-0173
Mailing Address - Fax:
Practice Address - Street 1:21701 LINCOLN DR
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:MI
Practice Address - Zip Code:48193-7589
Practice Address - Country:US
Practice Address - Phone:734-560-0173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty